又云∶凡伤损之证，有发热者，当分昼夜阴阳而治之。东垣曰∶昼则发热，夜
则安静，是阳气自旺于阳分也；昼则安静，夜则发热烦躁，是阳气下陷入阴中也，名
曰热入血室。如昼夜俱发热烦躁，是重阳无阴也，当急泻其阳而峻补其阴。夫热入
血室之证，妇人经水适来，或因损伤，或因大劳，或因大怒而发热必致前证，或有
言语谵妄，如见鬼神状者，犹宜小柴胡汤加生地主之。重阳无阴血虚者，亦用小柴
胡汤合四物汤治之。（论热分昼夜。）
又云∶凡伤损之证，有作渴者，若出血而作渴者，血脱也，四物汤加白术补之，
不应，加人参、黄 以补气，倍当归、熟地以养血。若溃后而作渴者，大补气血为
主。胃热津液耗散作渴者，用竹叶黄 汤。瘀血内停发热作渴者，用竹叶石膏汤。若
脓血大溃而作渴，或小便赤涩，或痛而不通，死在反掌，及痈疽溃烂后多有此证，非六味地黄丸不能救。（论作渴。）
又云∶凡伤损之证，有作呕者，或因痛不止，或因攻伐之剂而作呕者，皆胃气
伤也，四君子汤加芎、归、半夏、藿香、姜枣之类主之。或兼忿怒损伤而致呕者，气
逆也，小柴胡汤加山栀、枳壳、茯苓、桔梗之类治之。若胃中痰火盛而作呕者，二
陈汤加黄连、山栀、生姜治之。胃气虚寒而作呕者，补中益气汤加姜枣主之，或出
血过多，或溃后而作呕者，宜大补气血为主。（论作呕。）
又云∶凡伤损之证，出血过多，如面黑胸胀，或膈痛发喘，此肺气虚，瘀血入
肺，急以人参苏木饮救之。如咳血衄血，乃火盛气逆，血蕴于肺，宜用十味参苏饮救
之，加山栀、黄芩、苏木主之。面黑作喘之证，诸书未尝论及，治者不明，患者必
死。惟《产宝百问》内云∶产妇瘀血入肺，面黑作喘，用参苏饮救之，其方乃人参一
两，苏木二两作一剂煎服。（论面黑作喘。）
又云∶凡伤损之证，小便不利，若因出血，或平素阴虚火躁而渗泄之令不行者，
宜滋膀胱之阴。若因疼痛，或平素肺经气虚，不能生化肾水而小便短少者，当补脾
肺之气，滋其化源则小便自生。若误用分
利之剂，复损其阴，祸在反掌。经云∶气化则小便出焉。又云∶无阳则阴无以生，无
阴则阳无以化。亦有汗出不止而小便短少者，汗止便自利，犹忌分利渗泄之剂。（论小便不利。）
又云∶凡伤损之证，出血太多，或溃烂之际，收敛之后，如有寒热作痛，或自
汗盗汗，烦躁作渴，或遍身疼痛，肢体倦怠，牙关紧急，痰涎上壅等证，是血气虚
极而作变证也，当峻补元气为主。大凡伤损证有外邪，乃乘虚而入，犹当补助。作
外邪治之，祸不旋踵矣。（论血气内伤。）
又云∶凡伤损之证，筋糜肉烂，脓血大泄，阳亦随阴而走，元气丧败，理势必
然，气血不虚者鲜矣。智者审之。（论血气必虚。）
又云∶凡伤损之证，脓血大溃，血出过多，兼之恶寒发热， 痛口干，肝血自
然不足。况肝主筋，血去则筋无以养，筋无血养则燥，遂不能束骨而屈伸自如，故
有拘挛之象。宜圣愈汤加柴胡、木瓜、山栀、麦冬、五味子治之。如作风证一治，筋
愈燥而血愈涸，挛岂能伸乎！（论血虚筋挛。）
又云∶凡伤损之证，最忌骨气虚惫。肾主骨，肾水足则肝气充溢，经脉强健，虽
有伤损，气血不亏而溃敛以时，气路不致于上逆，痰涎何能而上壅！使肾气一虚，水
不能生木，则肝气奔腾而不下，痰气亦随之以上升，非风痰也，乃水泛白羊也，是
水泛为痰之证也。宜六味地黄丸或六味地黄汤加清肝之剂。（论肾虚气逆。）
又云∶凡伤损之证，其患已愈，而腿作痛，乃受患太重，脓血过多，疮虽愈而
肝经血气尚未充也，故湿热乘之，因虚而袭，以致作痛，非风证也。用八珍汤加牛
膝、木瓜、苍术、黄柏、防己、炙草以祛湿热，养阴血，痛渐止后去防己、黄柏服之，遂瘳。（论湿热乘肝。）
又云∶凡伤损之证，遍身作痒，或搔破如疮疥，此血不营于肌腠，当作血虚治
之。不应，兼补其气，亦有愈后身起白屑，
落而又起，或有如布帛一层隔于肌肤，乃气血俱虚，不能营于腠理。宜大补气血为
主，若作风邪治之，误矣。（论遍身作痒。）
又云∶凡伤损之证，肢体麻木，若口眼如故，腰背如常而肢体麻木者，气虚也。
盖血虚则气虚，故血虚之人肢体多麻木，此是阴虚火动之变证，实非风也。当用升阳
滋阴之剂，若作风治，凶在反掌。（论肢体作麻。）
又云∶凡伤损之证，如所伤之处不甚，克伐之剂未用，而四肢困倦，精神短少，懒
于动作，胸满气促，肢体沉重，气高而喘，身热而烦，心下痞满，不思饮食，自汗体
重，其脉洪大而头痛，是内伤元气之证，以补中益气汤主之。如在夏令是暑热内伤元
气之证，用清暑益气汤主之。若遇秋令是湿热内伤元气之证，以清燥汤主之。（论四肢倦怠。）
又云∶凡伤损之证，或其人素多湿痰，或又服辛热破血之剂，则湿热助痰流阻道
路，反致遍身作痛。丹溪曰∶东南之人多因湿土生痰，痰生热，热生风，证类中风，
惟宜清燥汤，或二陈汤加羌、防、归、芍、桔梗、炒芩、苍术治之。（论湿痰作痛。）
又云∶凡伤损之证，或手足生疮，在气血罕到之地，切不可用损元气之药。若
元气虚怯，邪气滋盛，溃烂延上必死，不溃而色黯者亦死。手足心背受病，色黑者
多死，手足节髀损去者不死。故伤损骨断，筋皮尚连者，急剪去之，若肉被伤欲去尚
连者亦剪之。不尔，溃及好肉，怯弱之人多致不救。如手足与指损去一节，可治不
死。惟去其半节留其半节，或骨断筋皮相连者，最为难治。（论气遏肉死。）
又云∶凡伤损之证，不可轻服乌附等味，盖其性味辛热，恐助火以益其患，其
平素有失血及血虚之人，虽在冬令，决不宜用，缘滞血得火而益伤，阴血得火而益
耗，运血得火而妄行，患肉得火而益坏，新肉得火而复溃，疼痛得火而益甚。若人平
素虚寒，或因病而阳气脱陷者，则用之不
在此例。（论用辛热之非。）
又云∶凡伤损之证，不宜敷贴硝黄之类，然其性味咸寒，恐济寒以益其伤。若
人平素虚弱，患而作痛，虽在夏令，亦不宜用。盖胃气得寒而不生，运气得寒而不
健，瘀血得寒而不行，腐肉得寒而不溃，新肉得寒而不生。若内有瘀血停滞，服以通
之，不在此例。（论用咸寒之非。）
又云∶凡伤损之证，近用黑羊皮热贴者，盖羊肉性热而补气，彼受刑太重，患
处内肉已坏，欲其腐溃者，用之成脓固速。若内非补剂壮其根本，毒瓦斯不能内侵，外
非砭刺泄其瘀秽，良肉不无伤坏，设受刑轻浅，外皮破伤，外用神效当归膏敷贴，则
丁痂不结，伤肉渐溃，死肉自败， 肿自退，黯色自消。内用四物汤加黄连、柴胡、
山栀、白术、茯苓，清肝木，健脾土自愈。若专用黑羊皮罨贴，反助其毒，腐溃益深，
难于收敛，智者审之。（论用黑羊皮之非。）
又云∶凡伤损之证，瘀血已去而肌肉糜烂，不肯收敛，属气血俱虚，大补犹恐
不及，岂可复用行气破血之剂，又贼其元气耶！当时诸君多蹈此弊，而怯弱者皆致不救。（论用行气之非。）
又云∶凡伤损之证，遇杖坠跌扑，患处如有瘀血，止宜砭出，服壮元气之剂。盖
其气血已损，切不可孟浪妄行妄下。此肢末之地，血气难到，再用行气下血等药，复
损脾胃元气，则运气愈难营达于下，而反为败证。怯弱者多致夭枉。（论下血之非。）
又云∶或问寒凉能消肿止痛，何以用之反致内溃，不能生肌，且有致死者？答
曰∶寒凉之剂敷于肌肉而不知痛者，是一遇寒凉，血因之以凝，气因之以滞，气血
凝滞，肌肉皆为死阴，宁复有知其疼痛也哉？故毒不出而内攻，多致不救。当知气
血得温则行，得寒则凝，寒极生热，变化为脓，腐溃益深，气血既败，肌肉无由而
生，欲望其不危也，几希！（论用寒药之非。）
又云∶凡伤损之证，遇杖扑重者，外
皮不破而内肉糜烂，与血相和，甚者臀腿如皮囊盛糊，然若不砭刺发泄，为患匪轻。
故当时大理寺大狱诸君失于不砭，以致不起者多矣。是不知伤重而内有瘀秽者也，须
急去之，即服补益之剂以固根本，庶保无虞。古人谓瘀秽恶于虎野狼，毒于蛇趸，去
之稍缓则戕性命，非虚言也，医者三复之。（论不砭之非）
又云∶凡伤损之证，贵乎大补气血，则腐肉易于溃烂，疮口易于生肌。每见治者
不知气血亏损，往往多用十宣散，又以方内参、 、芎、归为补益之剂，嫌其中满，
多用不过钱许，以浓朴、防己为清毒之药，因其行散，动则倍加，如此何益于气血，而
欲责其速溃速敛速生肌乎？无怪其烦躁作渴，饮食益少，因之不起者众矣。（论不补益之非。）
《得效》云∶凡堕压死者，急安好处，以袖掩其口鼻上一食顷，候眼开，先与热
小便饮之，若初觉气绝，急擘开口以热小便灌之，利去瘀血。（以下载《东医宝鉴》）
又云∶凡跌打压伤，或从高堕落，皆惊动四肢五脏，必有恶血在内，专怕恶心。
先用通二便药和童便服之，立效，大小肠俱通利，则自无烦闷攻心之患矣。
又云∶头上有伤，或打破，或金刃伤，用药糊角缚紧，不使伤风，慎之。
又云∶如伤脏腑致命处，一观其脉虚促，危。
《纲目》云∶卒堕颠、压倒、打死，心头温，皆可救。将本人如僧打坐，令一人
将其头发控放低，以半夏或皂角末吹令入鼻中，如活，却以姜汁香油打匀灌之。
《入门》云∶若取药不及，急拨开口，以热小便多灌之。
又云∶凡伤损专主血论，肝主血，不问何经所伤，恶血必归于肝，流于胁，郁
于腹而作腹痛，实者下之。
又云∶凡出血已多而又呕血不止者，难治，宜用苏木煎汤，调蚌霜散服之。
又云∶凡折伤外损筋骨者，可治。内损脏腑里膜及破阴子耳后者，并不治。
《医鉴》曰∶人为刀斧所伤，或堕落险地，或扑身体损伤筋骨皮肉，皆出血不止，
或瘀血停积，若去之不早，则有入腹攻心之患。
又云∶打仆伤损，去血过多，脉当虚细，若得急疾大数者，死。
《丹心》云∶跌仆伤损，须用苏木活血，黄连降火，白术和中，以童便煎服，如伤在上，宜饮韭汁。
《回春》云∶凡斗殴被打，内有瘀血，其脉坚强者，生，小弱者，死。（《脉经》）
《得效》云∶凡脚手各有六出臼，四折骨，每手有三处出臼，脚亦三处出臼，手
掌根出臼。其骨交互相锁，或出臼则是挫出锁骨之外，须是搦骨于锁骨下归窠，若
出外则须搦入内，若出内则须搦入外，方入窠臼。只有手拽，断难入窠，十有八九成痼疾也。
又云∶骨节损折，肘臂腰膝出臼蹉跌，须用法整顿归源。先用麻药与服，使不知痛，然后可用手法。
又云∶搦骨归窠，用竹一片，生柳木板片尤佳。夹定一边，一边不用夹，须存
屈直处，时时拽曲拽直。不然，则愈后曲直不得。
又云∶凡骨碎者，须用麻药（即草乌散）与服。或刀割开；甚者用剪剪去骨锋，使不
冲肉。或有粉碎者，镰去细骨，免脓血之祸。且以药水一日一洗，莫令臭秽。
又云∶凡骨碎者，用接骨药火上化开糊骨上，然后夹定，外用夹骨法、活血散、接骨丹、二生膏、糯米膏。
又云∶淋洗用蔓荆散。
又说：凡是跌打损伤的病症，如果有发热的，应当根据昼夜阴阳的不同来治疗。李东垣说：白天发热，夜间安静，这是阳气在阳分旺盛；白天安静，夜间发热烦躁，这是阳气下陷进入阴分，称为热入血室。如果昼夜都发热烦躁，这是重阳无阴（阳盛阴虚），应当紧急泻其阳而峻补其阴。所谓热入血室的病症，多见于妇女月经刚来时，或因损伤，或因过度劳累，或因大怒而导致发热并出现上述症状，或者出现言语错乱、胡言乱语，如同看见鬼神一样的状态，仍然适宜用小柴胡汤加生地黄主治。对于重阳无阴、血虚的患者，也使用小柴胡汤合四物汤治疗。（论述发热分昼夜）
又说：凡是跌打损伤的病症，如果有口渴的，如果是出血后导致口渴，这是血脱，用四物汤加白术补益，如果无效，再加人参、黄芪以补气，加倍当归、熟地黄以养血。如果是溃烂后导致口渴，以大补气血为主。如果是胃热津液耗散导致的口渴，用竹叶黄芪汤。如果是瘀血内停、发热导致的口渴，用竹叶石膏汤。如果是脓血大量溃泄后导致口渴，或者小便赤涩，或者疼痛且不通利，病情危急，生死只在顷刻之间，以及痈疽溃烂后多有此证，非六味地黄丸不能救治。（论述口渴）
又说：凡是跌打损伤的病症，如果有呕吐的，可能是因为疼痛不止，或者因为攻伐药物导致呕吐，这都是胃气受伤，用四君子汤加川芎、当归、半夏、藿香、生姜、大枣等药主治。或者兼有愤怒损伤导致呕吐的，这是气逆，用小柴胡汤加山栀、枳壳、茯苓、桔梗等药治疗。如果是胃中痰火盛导致呕吐的，用二陈汤加黄连、山栀、生姜治疗。如果是胃气虚寒导致呕吐的，用补中益气汤加生姜、大枣主治，或者因为出血过多，或者溃烂后导致呕吐的，宜以大补气血为主。（论述呕吐）
又说：凡是跌打损伤的病症，出血过多，如面色发黑、胸腹胀满，或者膈部疼痛、气喘，这是肺气虚，瘀血进入肺脏，紧急用人参苏木饮救治。如果是咳血、鼻衄，这是火盛气逆，血液蕴积于肺，适宜用十味参苏饮救治，加山栀、黄芩、苏木主治。面色发黑伴气喘的病症，各书未曾论及，医者不明白，患者必死。只有《产宝百问》中说：产妇因瘀血入肺，面色发黑伴气喘，用人参苏木饮救治，该方用人参一两，苏木二两，作为一剂煎服。（论述面色发黑伴气喘）
又说：凡是跌打损伤的病症，小便不利，如果是因出血，或者平时阴虚火躁导致渗泄功能不行，应当滋补肾膀胱之阴。如果是因疼痛，或者平时肺经气虚，不能生化肾水导致小便短少，应当补益脾肺之气，滋其化源则小便自然生成。如果误用分利（利尿）的药物，反而损伤其阴，祸患就在顷刻之间。经文说：气化则小便出焉。又说：无阳则阴无以生，无阴则阳无以化。也有出汗不止导致小便短少的，汗止则小便自然通利，此时仍忌讳使用分利渗泄的药物。（论述小便不利）
又说：凡是跌打损伤的病症，出血太多，或者溃烂之际，收敛之后，如果出现寒热作痛，或者自汗盗汗，烦躁口渴，或者遍身疼痛，肢体倦怠，牙关紧急，痰涎上壅等症状，这是血气极度虚弱而产生的变证，应当以大补元气为主。大凡损伤病症如果有外邪，是乘虚而入，还应当补助正气。如果当作外邪治疗，祸患随即而至。（论述血气内伤）
又说：凡是跌打损伤的病症，筋糜肉烂，脓血大量泄出，阳气也随着阴血流失，元气丧败，情理势态必然如此，气血不虚的情况很少见。明智的人应当审慎对待。（论述血气必虚）
又说：凡是跌打损伤的病症，脓血大量溃泄，出血过多，兼有恶寒发热，身体疼痛口干，肝血自然不足。况且肝主筋，血去则筋得不到滋养，筋无血养则干燥，于是不能约束骨骼而屈伸自如，所以有拘挛的现象。适宜用圣愈汤加柴胡、木瓜、山栀、麦冬、五味子治疗。如果当作风证治疗，筋更加干燥而血液更加枯竭，拘挛怎么能伸直呢！（论述血虚筋挛）
又说：凡是跌打损伤的病症，最忌讳骨气虚惫。肾主骨，肾水充足则肝气充溢，经脉强健，虽然有损伤，气血不亏且按时溃敛，气路不至于上逆，痰涎怎么能向上壅滞！如果肾气一虚，水不能生木，则肝气奔腾而下不去，痰气也随之上升，这不是风痰，而是水泛为痰（肾虚水泛成痰），是水泛为痰的病症。适宜用六味地黄丸或六味地黄汤加清肝的药物。（论述肾虚气逆）
又说：凡是跌打损伤的病症，患处已经痊愈，但腿部作痛，是因为受伤太重，脓血过多，疮虽愈但肝经血气尚未充盈，所以湿热乘虚侵袭，导致作痛，这不是风证。用八珍汤加牛膝、木瓜、苍术、黄柏、防己、炙甘草以祛除湿热，滋养阴血，疼痛逐渐停止后去掉防己、黄柏继续服用，病就好了。（论述湿热乘肝）
又说：凡是跌打损伤的病症，遍身作痒，或者抓破如疮疥，这是血不能营养肌肤腠理，应当当作血虚治疗。如果无效，兼补其气。也有痊愈后身上起白屑，脱落又起，或者有像布帛一层隔于肌肤的感觉，这是气血俱虚，不能营养腠理。宜以大补气血为主，如果当作风邪治疗，就错了。（论述遍身作痒）
又说：凡是跌打损伤的病症，肢体麻木，如果口眼正常，腰背如常而肢体麻木，这是气虚。因为血虚则气虚，所以血虚之人肢体多麻木，这是阴虚火动的变证，实在不是风证。应当用升阳滋阴的药物，如果当作风证治疗，凶险就在顷刻之间。（论述肢体麻木）
又说：凡是跌打损伤的病症，如果受伤之处不严重，未使用攻伐药物，而出现四肢困倦，精神短少，懒于动作，胸满气促，肢体沉重，气高而喘，身热而烦，心下痞满，不思饮食，自汗体重，脉洪大而头痛，这是内伤元气的病症，用补中益气汤主治。如果在夏季，是暑热内伤元气的病症，用清暑益气汤主治。如果遇到秋季，是湿热内伤元气的病症，用清燥汤主治。（论述四肢倦怠）
又说：凡是跌打损伤的病症，或者其人平时多湿痰，或者又服用辛热破血的药物，则湿热助痰流阻道路，反而导致遍身作痛。朱丹溪说：东南地区的人多因湿土生痰，痰生热，热生风，证候类似中风，只适宜用清燥汤，或者二陈汤加羌活、防风、当归、芍药、桔梗、炒黄芩、苍术治疗。（论述湿痰作痛）
又说：凡是跌打损伤的病症，或者手足生疮，在气血罕到的地方，切不可使用损耗元气的药物。如果元气虚怯，邪气滋盛，溃烂延上必死，不溃烂而颜色黯黑的也死。手足心背受病，颜色发黑的多死，手足节髀损去者不死。所以损伤骨折，筋皮尚连着的，紧急剪去之，如果肉被伤欲去尚连着者也剪去。不然，溃烂波及好肉，体弱之人多致无法救治。如手足与指损去一节，可治不死。只是去其半节留其半节，或者骨断筋皮相连者，最为难治。（论述气遏肉死）
又说：凡是跌打损伤的病症，不可轻率服用乌头、附子等药，因为它们性味辛热，恐怕助火以加重病患。那些平时有失血及血虚的人，即使在冬季，也决不宜用，因为瘀血得火而更伤，阴血得火而更耗，运血得火而妄行，患肉得火而更坏，新肉得火而复溃，疼痛得火而更甚。如果人平时虚寒，或者因病阳气脱陷的，则不在此例。（论述用辛热药的弊端）
又说：凡是跌打损伤的病症，不宜敷贴硝石、大黄之类，然而它们性味咸寒，恐怕济寒以加重损伤。如果人平时虚弱，患病作痛，即使在夏季，也不宜用。因为胃气得寒而不生，运气得寒而不健，瘀血得寒而不行，腐肉得寒而不溃，新肉得寒而不生。如果内有瘀血停滞，服用通利药物，不在此例。（论述用咸寒药的弊端）
又说：凡是跌打损伤的病症，近来有用黑羊皮热敷的，因为羊肉性热而补气，彼处受刑太重，患处内肉已坏，想要它腐溃的，用之成脓确实快。如果内部不用补剂壮其根本，毒瓦斯不能内侵，外部不用砭刺泄其瘀秽，良肉无不伤坏。如果受刑轻浅，外皮破伤，外用神效当归膏敷贴，则丁甲不结，伤肉渐溃，死肉自败，肿胀自退，黯色自消。内部用四物汤加黄连、柴胡、山栀、白术、茯苓，清肝木，健脾土自愈。如果专用黑羊皮罨贴，反而助其毒，腐溃更深，难于收敛，明智的人应当审慎对待。（论述用黑羊皮的弊端）
又说：凡是跌打损伤的病症，瘀血已去而肌肉糜烂，不肯收敛，属于气血俱虚，大补还怕来不及，岂可再用行气破血的药物，又贼害其元气耶！当时许多医生多犯此弊，而体弱者皆致无法救治。（论述用行气药的弊端）
又说：凡是跌打损伤的病症，遇到杖责坠跌扑打，患处如有瘀血，只适宜砭刺放出，服用壮元气的药物。因为气血已损，切不可鲁莽妄行妄下。这是肢末之地，血气难到，再用行气下血等药，反而损伤脾胃元气，则运气更难营达于下，反而成为败证。体弱者多致夭折。（论述下血法的弊端）
又说：有人问：寒凉能消肿止痛，为什么用了反而导致内溃，不能生肌，且有致死的？回答说：寒凉的药剂敷于肌肉而不知痛的，是一遇寒凉，血因之凝结，气因之阻滞，气血凝滞，肌肉皆为死阴，哪里还有知道疼痛的呢？所以毒不出而内攻，多致无法救治。应当知道气血得温则行，得寒则凝，寒极生热，变化为脓，腐溃更深，气血既败，肌肉无由而生，希望它不危险，太少了！（论述用寒药的弊端）
又说：凡是跌打损伤的病症，遇到杖扑重的，外皮不破而内肉糜烂，与血相和，严重的臀部大腿像皮囊盛糊状，然而如果不砭刺发泄，为患不小。所以当时大理寺大狱各位官员失于不砭，以致不起病的很多了。这是不知道伤重而内有瘀秽的缘故，必须紧急去除，即服用补益药物以固根本，庶几保全无忧。古人说瘀秽恶于虎狼，毒于蛇蝎，去除稍缓则戕害性命，不是虚言，医者应反复思考。（论述不砭刺的弊端）
又说：凡是跌打损伤的病症，贵在大的补益气血，则腐肉易于溃烂，疮口易于生肌。常见治病者不知道气血亏损，往往多用十宣散，又以方内人参、黄芪、川芎、当归为补益药物，嫌弃其中满，多用不过一钱许，用厚朴、防己为清毒药物，因其行散，动则倍加，这样对气血有什么益处，而想要求它速溃速敛速生肌呢？难怪其烦躁口渴，饮食更少，因此不起病的众多了。（论述不补益的弊端）
《得效方》说：凡是堕压死者，紧急安置在舒适的地方，用袖子掩住其口鼻上一顿饭的时间，等眼睛睁开，先给喝热小便，如果初觉气绝，紧急掰开口用热小便灌之，利去瘀血。（以下记载于《东医宝鉴》）
又说：凡是跌打压伤，或者从高坠落，都惊动四肢五脏，必有恶血在内，特别怕恶心。先用通利二便的药物和童便服用，立效，大小肠俱通利，则自然没有烦闷攻心的忧患了。
又说：头上有伤，或者打破，或者金刃伤，用药糊角缚紧，不让伤风，务必谨慎。
又说：如果伤及脏腑致命处，一看其脉虚促，危重。
《本草纲目》说：突然坠落颠仆、压倒、打死，心头温暖，都可以救治。将本人摆成僧人打坐的姿势，令一人将其头发控放低，用半夏或皂角末吹入鼻中，如果活了，再用姜汁香油打匀灌之。
《医学入门》说：如果取药不及，紧急拨开口，用热小便多灌之。
又说：凡是损伤专门从血论治，肝主血，不问哪条经络所伤，恶血必归于肝，流于胁，郁于腹而作腹痛，实证的下之。
又说：凡是出血已多而又呕血不止的，难治，适宜用苏木煎汤，调蚌霜散服用。
又说：凡是折伤外损筋骨者，可治。内损脏腑里膜及破阴子耳后者，并不治。
《医鉴》说：人被刀斧所伤，或者堕落险地，或者扑身体损伤筋骨皮肉，都出血不止，或者瘀血停积，如果去除不早，则有入腹攻心的忧患。
又说：打仆伤损，去血过多，脉应当虚细，如果得到急疾大数的脉象，死。
《丹心》说：跌仆伤损，须用苏木活血，黄连降火，白术和中，用童便煎服，如果伤在上部，适宜饮韭汁。
《回春》说：凡是斗殴被打，内有瘀血，其脉坚强的，生，小弱的，死。（《脉经》）
《得效方》说：凡是手脚各有六个出臼（关节脱位），四个折骨，每手有三处出臼，脚亦三处出臼，手掌根出臼。其骨交互相锁，或者出臼则是挫出锁骨之外，必须捏骨于锁骨下归窠，如果出外则须搦入内，如果出内则须搦入外，方才入窠臼。只有手拽，断难入窠，十有八九成痼疾也。
又说：骨节损折，肘臂腰膝出臼蹉跌，须用法整顿归源。先用麻药与服，使不知痛，然后可用手法。
又说：捏骨归窠，用竹一片，生柳木板片尤佳。夹定一边，一边不用夹，须存屈直处，时时拽曲拽直。不然，则愈后曲直不得。
又说：凡是骨碎的，须用麻药（即草乌散）与服。或者刀割开；严重的用剪刀剪去骨锋，使不冲肉。或者有粉碎的，镰去细骨，免脓血之祸。且以药水一日一洗，莫令臭秽。
It is also said: In cases of traumatic injury, if there is fever, treatment should be differentiated according to the yin and yang of day and night. Li Dongyuan said: Fever during the day and quietness at night indicates that Yang Qi is flourishing in the Yang aspect; quietness during the day and fever with irritability at night indicates that Yang Qi has sunk into the Yin aspect, a condition named *Re Ru Xue Shi* (Heat Entering the Blood Chamber). If there is fever and irritability both day and night, this represents Extreme Yang without Yin (Yin deficiency), and one should urgently drain the Yang and vigorously tonify the Yin. Regarding the condition of Heat Entering the Blood Chamber, it often occurs when a woman's menstruation has just begun, or due to trauma, excessive labor, or severe anger causing fever and the aforementioned symptoms, or presenting with delirious speech as if seeing spirits; in such cases, *Xiao Chai Hu Tang* (Minor Bupleurum Decoction) added with *Sheng Di Huang* (Rehmanniae Radix Recens) is appropriate. For those with Extreme Yang without Yin and blood deficiency, *Xiao Chai Hu Tang* combined with *Si Wu Tang* (Four Substance Decoction) is used. (Discussion on differentiating fever by day and night.)
It is also said: In cases of traumatic injury, if there is thirst, if thirst arises after bleeding, this is Blood depletion; treat with *Si Wu Tang* (Four Substance Decoction) added with *Bai Zhu* (Atractylodis Macrocephalae Rhizoma) to tonify. If ineffective, add *Ren Shen* (Ginseng Radix et Rhizoma) and *Huang Qi* (Astragali Radix) to tonify Qi, and double the dosage of *Dang Gui* (Angelicae Sinensis Radix) and *Shu Di Huang* (Rehmanniae Radix Preparata) to nourish Blood. If thirst arises after ulceration, the main treatment is vigorous tonification of Qi and Blood. If thirst is caused by Stomach heat consuming body fluids, use *Zhu Ye Huang Qi Tang* (Bamboo Leaf and Astragalus Decoction). If thirst is caused by internal retention of Blood stasis and fever, use *Zhu Ye Shi Gao Tang* (Bamboo Leaf and Gypsum Decoction). If thirst arises after massive discharge of pus and blood, or accompanied by red and scanty urination, or painful and obstructed urination, death may occur swiftly; this condition often follows the ulceration of carbuncles and sores, and only *Liu Wei Di Huang Wan* (Six-Ingredient Pill with Rehmannia) can save the patient. (Discussion on thirst.)
It is also said: In cases of traumatic injury, if there is vomiting, whether due to unceasing pain or due to purgative drugs, this indicates injury to Stomach Qi. Treat with *Si Jun Zi Tang* (Four Gentlemen Decoction) added with *Xiong* (Chuanxiong Rhizome), *Gui* (Dang Gui), *Ban Xia* (Pinelliae Tuber), *Huo Xiang* (Pogostemonis Herba), *Jiang* (Zingiberis Rhizoma), and *Zao* (Jujubae Fructus). If vomiting is caused by anger-induced injury, this is rebellious Qi; treat with *Xiao Chai Hu Tang* (Minor Bupleurum Decoction) added with *Shan Zhi* (Gardeniae Fructus), *Zhi Ke* (Aurantii Fructus), *Fu Ling* (Poria), and *Jie Geng* (Platycodonis Radix). If vomiting is caused by abundant Phlegm-Fire in the Stomach, treat with *Er Chen Tang* (Two-Aged Decoction) added with *Huang Lian* (Coptidis Rhizoma), *Shan Zhi*, and *Sheng Jiang* (Zingiberis Rhizoma Recens). If vomiting is caused by Stomach Qi deficiency and cold, treat with *Bu Zhong Yi Qi Tang* (Tonify the Middle and Augment the Qi Decoction) added with *Jiang* and *Zao*; or if vomiting occurs due to excessive bleeding or post-ulceration, the main treatment should be vigorous tonification of Qi and Blood. (Discussion on vomiting.)
It is also said: In cases of traumatic injury with excessive bleeding, if the face turns black and the chest is distended, or if there is pain in the diaphragm and panting, this indicates Lung Qi deficiency with Blood stasis entering the Lung. Urgently rescue with *Ren Shen Su Mu Yin* (Ginseng and Sappanwood Drink). If there is hemoptysis or epistaxis, this is due to excessive Fire and rebellious Qi with blood accumulating in the Lung; rescue with *Shi Wei Ren Shen Yin* (Ten-Ingredient Ginseng Drink) added with *Shan Zhi*, *Huang Qin* (Scutellariae Radix), and *Su Mu* (Sappanwood). The condition of a black face with panting is not discussed in other texts; if physicians do not understand it, the patient will surely die. Only in *Chan Bao Bai Wen* (Hundred Questions on Obstetrics) is it stated: For postpartum women with Blood stasis entering the Lung, causing a black face and panting, rescue with *Ren Shen Yin* (Ginseng Drink); the formula uses one liang of *Ren Shen* and two liang of *Su Mu* as one dose for decoction and administration. (Discussion on black face with panting.)
It is also said: In cases of traumatic injury, if urination is difficult, if it is due to bleeding or chronic Yin deficiency with hyperactive Fire impairing excretion, one should nourish the Yin of the Bladder. If it is due to pain or chronic Qi deficiency of the Lung Meridian failing to generate Kidney Water leading to short urination, one should tonify the Qi of the Spleen and Lung; nourishing the source of transformation will naturally restore urination. If one mistakenly uses diuretic agents, it will further damage Yin, bringing disaster swiftly. The Classics state: "When Qi transforms, urine is excreted." It also states: "Without Yang, Yin cannot be generated; without Yin, Yang cannot transform." There are also cases where incessant sweating leads to short urination; once sweating stops, urination naturally becomes adequate, and one must still avoid diuretic and draining agents. (Discussion on difficult urination.)
It is also said: In cases of traumatic injury with excessive bleeding, or during ulceration and subsequent healing, if there are alternating chills and fever with pain, spontaneous or nocturnal sweating, irritability and thirst, generalized body pain, limb fatigue, lockjaw, and phlegm-fluids surging upward, these are changes resulting from extreme deficiency of Qi and Blood. The primary treatment should be vigorous tonification of Yuan Qi (Original Qi). Generally, if external pathogens invade traumatic injuries, they enter through deficiency, and one should still support the righteous Qi. Treating it merely as an external pathogen will bring swift disaster. (Discussion on internal injury of Qi and Blood.)
It is also said: In cases of traumatic injury where tendons are macerated and flesh rots, with massive discharge of pus and blood, Yang Qi follows the loss of Yin Blood, and Yuan Qi is exhausted; this is inevitable. It is rare for Qi and Blood to remain non-deficient. Wise practitioners should exercise caution. (Discussion on the inevitability of Qi and Blood deficiency.)
It is also said: In cases of traumatic injury with massive discharge of pus and blood and excessive bleeding, accompanied by aversion to cold, fever, body pain, and dry mouth, Liver Blood is naturally insufficient. Since the Liver governs the sinews, loss of Blood means sinews lack nourishment; without Blood nourishment, sinews become dry and cannot bind bones for free flexion and extension, leading to spasms. Treat with *Sheng Yu Tang* (Holy Rescue Decoction) added with *Chai Hu* (Bupleuri Radix), *Mu Gua* (Chaenomelis Fructus), *Shan Zhi*, *Mai Dong* (Ophiopogonis Radix), and *Wu Wei Zi* (Schisandrae Fructus). If treated as a Wind syndrome, sinews will become drier and Blood more depleted, making extension impossible! (Discussion on Blood deficiency causing tendon spasms.)
It is also said: In cases of traumatic injury, bone Qi deficiency and exhaustion are most taboo. The Kidneys govern bones; sufficient Kidney Water fills Liver Qi and strengthens meridians. Even with injury, if Qi and Blood are not deficient and healing occurs on time, Qi pathways will not rebel upward, and how can phlegm-fluids surge? If Kidney Qi becomes deficient, Water fails to generate Wood, causing Liver Qi to surge downward uncontrollably, and Phlegm-Qi rises with it. This is not Wind-Phlegm, but Phlegm generated by Water overflowing (Kidney deficiency leading to water flooding transforming into phlegm). Treat with *Liu Wei Di Huang Wan* (Six-Ingredient Pill with Rehmannia) or *Liu Wei Di Huang Tang* (Decoction) added with Liver-clearing herbs. (Discussion on Kidney deficiency causing Qi rebellion.)
It is also said: In cases of traumatic injury, if the lesion has healed but the leg hurts, it is because the injury was severe, pus and blood were excessive, and although the sore has healed, Liver Meridian Qi and Blood have not yet replenished. Thus, Damp-Heat takes advantage of the deficiency to invade, causing pain; this is not a Wind syndrome. Use *Ba Zhen Tang* (Eight-Treasure Decoction) added with *Niu Xi* (Achyranthis Bidentatae Radix), *Mu Gua*, *Cang Zhu* (Atractylodis Rhizoma), *Huang Bo* (Phellodendri Cortex), *Fang Ji* (Stephaniae Tetrandrae Radix), and *Zhi Gan Cao* (Prepared Licorice Root) to dispel Damp-Heat and nourish Yin Blood. After pain subsides, remove *Fang Ji* and *Huang Bo* and continue taking the formula until cured. (Discussion on Damp-Heat invading the Liver.)
It is also said: In cases of traumatic injury, generalized itching or scratching until resembling sores indicates that Blood fails to nourish the muscle and interstices; treat as Blood deficiency. If ineffective, tonify Qi concurrently. Some patients develop white scales after healing, falling off and recurring, or feeling like a layer of cloth separates the skin; this indicates dual deficiency of Qi and Blood failing to nourish the interstices. The main treatment should be vigorous tonification of Qi and Blood. Treating it as Wind-Evil is a mistake. (Discussion on generalized itching.)
It is also said: In cases of traumatic injury, numbness of limbs with normal mouth/eyes and back/waist indicates Qi deficiency. Since Blood deficiency leads to Qi deficiency, those with Blood deficiency often experience limb numbness; this is a change due to Yin deficiency and Fire movement, truly not Wind. Use ascending-Yang and nourishing-Yin formulas. Treating it as Wind brings swift danger. (Discussion on limb numbness.)
It is also said: In cases of traumatic injury, if the injury is minor and purgatives were not used, but there is limb fatigue, reduced spirit, reluctance to move, chest fullness, shortness of breath, heavy limbs, rapid breathing, fever with irritability, epigastric fullness, loss of appetite, spontaneous sweating, heavy body, and a large headache with a洪大 (Surging-Large) pulse, this is an internal injury of Yuan Qi. Treat with *Bu Zhong Yi Qi Tang* (Tonify the Middle and Augment the Qi Decoction). If in summer, it is Summer-Heat internally injuring Yuan Qi; treat with *Qing Shu Yi Qi Tang* (Clear Summer-Heat and Augment Qi Decoction). If in autumn, it is Damp-Heat internally injuring Yuan Qi; treat with *Qing Zao Tang* (Clear Dryness Decoction). (Discussion on limb fatigue.)
It is also said: In cases of traumatic injury, if the person usually has much Damp-Phlegm, or has taken acrid-hot blood-breaking drugs, Damp-Heat assists Phlegm to block pathways, causing generalized pain. Danxi said: People in the Southeast often have Phlegm generated by damp earth; Phlegm generates Heat, Heat generates Wind, resembling stroke. Only *Qing Zao Tang* or *Er Chen Tang* (Two-Aged Decoction) added with *Qiang Huo* (Notopterygii Rhizoma et Radix), *Fang Feng* (Saposhnikoviae Radix), *Dang Gui*, *Bai Shao* (Paeoniae Radix Alba), *Jie Geng*, fried *Huang Qin*, and *Cang Zhu* is suitable. (Discussion on pain from Damp-Phlegm.)
It is also said: In cases of traumatic injury, if sores appear on hands or feet in areas rarely reached by Qi and Blood, never use drugs that damage Yuan Qi. If Yuan Qi is weak and Evil Qi flourishes, spreading ulceration leads to death; non-spreading dark color also leads to death. Black color on palms/soles/dorsum of hands/feet often indicates death; loss of joints/thighs does not necessarily mean death. Therefore, if bone fracture with tendon/skin connection exists, cut it off urgently; if flesh is damaged but still connected, cut it off. Otherwise, ulceration spreads to healthy flesh, and weak patients often die. Loss of one segment of fingers/toes is treatable; loss of half a segment or bone fracture with tendon/skin connection is most difficult to treat. (Discussion on Qi obstruction causing flesh death.)
It is also said: In cases of traumatic injury, do not lightly administer Wu Tou (Aconiti Lateralis Radix Preparata) or Fu Zi (Aconiti Radix Preparata) due to their acrid-hot nature, which may assist Fire and worsen the condition. Those with chronic blood loss or Blood deficiency should absolutely avoid them, even in winter, because Blood stasis worsens with Fire, Yin Blood depletes with Fire, circulating Blood runs recklessly with Fire, injured flesh deteriorates with Fire, new flesh ulcerates with Fire, and pain intensifies with Fire. However, if the person is constitutionally deficient-cold or has Yang collapse due to illness, this rule does not apply. (Discussion on the impropriety of acrid-hot drugs.)
It is also said: In cases of traumatic injury, do not apply Xiao (Natrii Sulfas) or Huang Bo (Phellodendri Cortex) etc., as their salty-cold nature may aggravate cold and injury. If the person is constitutionally weak and painful, avoid them even in summer. Cold prevents Stomach Qi generation, impairs circulation, stagnates Blood stasis, prevents rotting flesh from discharging, and hinders new flesh growth. However, if there is internal Blood stasis, using draining drugs is acceptable. (Discussion on the impropriety of salty-cold drugs.)
It is also said: Recently, hot black sheepskin patches have been used. Mutton is hot and tonifies Qi; for severe injuries where internal flesh is damaged and suppuration is desired, this accelerates pus formation. However, without internal tonic drugs to strengthen the root, toxins invade internally; without external scarification to drain filth, healthy flesh is damaged. For mild injuries with broken skin, apply *Shen Xiao Dang Gui Gao* (Miraculous Efficacy Angelica Ointment) externally; scabs will not form, injured flesh will gradually suppurate, dead flesh will decay, swelling will subside, and dark color will fade. Internally, use *Si Wu Tang* (Four Substance Decoction) added with *Huang Lian*, *Chai Hu*, *Shan Zhi*, *Bai Zhu*, and *Fu Ling* to clear Liver Wood and strengthen Spleen Earth for self-healing. Using only black sheepskin patches instead assists toxin, deepens ulceration, and hinders healing; wise practitioners should be cautious. (Discussion on the impropriety of black sheepskin patches.)
It is also said: In cases of traumatic injury, if Blood stasis is gone but flesh erodes and refuses to heal, it belongs to dual deficiency of Qi and Blood; vigorous tonification may still be insufficient. How can one use Qi-moving and Blood-breaking drugs, thereby stealing Yuan Qi! Many doctors at the time fell into this error, causing weak patients to die. (Discussion on the impropriety of Qi-moving drugs.)
It is also said: In cases of traumatic injury from beating or falling, if there is Blood stasis at the site, only scarification should be used to release it, followed by drugs strengthening Yuan Qi. Since Qi and Blood are already damaged, reckless purging is forbidden. These are extremities where Qi and Blood are hard to reach; using Qi-moving and Blood-draining drugs further damages Spleen-Stomach Yuan Qi, making circulation to the lower parts even harder, leading to defeat syndromes. Weak patients often die prematurely. (Discussion on the impropriety of blood-draining methods.)
It is also asked: Cold-cooling drugs reduce swelling and relieve pain; why do they cause internal ulceration, prevent flesh regeneration, and even cause death? Answer: When cold-cooling agents are applied to muscles without pain sensation, upon exposure to cold, Blood coagulates and Qi stagnates. With stagnant Qi and Blood, muscles become dead Yin, losing pain perception. Thus, toxins do not exit but attack inward, often leading to death. One must know that Qi and Blood flow with warmth and coagulate with cold; extreme cold generates Heat, transforming into pus, deepening ulceration. Once Qi and Blood are defeated, muscles cannot regenerate; hoping for safety is slim! (Discussion on the impropriety of cold drugs.)
It is also said: In cases of traumatic injury from severe beating, if the skin is intact but internal flesh is eroded and mixed with blood,严重时 buttocks and thighs resemble bags filled with paste. If not scarified to vent, the harm is significant. Many officials in the Dali Temple prisons died because they failed to scarify, not realizing severe injury with internal filth. Filth must be urgently removed, followed by tonic drugs to secure the root, ensuring safety. Ancients said filth is worse than tigers and wolves, more toxic than snakes and scorpions; delaying removal kills life. This is not empty talk; physicians must reflect repeatedly. (Discussion on the impropriety of not scarifying.)
It is also said: In cases of traumatic injury, vigorous tonification of Qi and Blood is crucial; this facilitates rotting flesh discharge and promotes flesh regeneration. Often, physicians ignore Qi and Blood deficiency, overusing *Shi Xuan San* (Ten-Venations Powder) and considering *Ren Shen*, *Huang Qi*, *Xiong*, and *Gui* within it as tonics. Disliking its cloying nature, they use less than one qian, adding *Hou Po* (Magnoliae Officinalis Cortex) and *Fang Ji* as detoxifying drugs. Due to their dispersing action, doses are doubled. How does this benefit Qi and Blood, while expecting rapid suppuration, healing, and regeneration? No wonder patients suffer irritability, thirst, reduced intake, and many die. (Discussion on the impropriety of lacking tonification.)
*De Xiao Fang* says: For those crushed or pressed to death, place them comfortably, cover mouth and nose with a sleeve for the duration of a meal, wait for eyes to open, then give hot urine to drink. If initially found breathless, forcibly open mouth and灌 (pour) hot urine to drain Blood stasis. (Recorded below in *Dongui Bogam*)
It is also said: For falls or crushing injuries, shock affects four limbs and five Zang organs, inevitably leaving Evil Blood inside. Nausea is particularly feared. First, use drugs promoting bowel/bladder opening mixed with Child's Urine (*Tong Bian*). Effect is immediate; if Large and Small Intestines are unobstructed, there is no worry of distress attacking the Heart.
It is also said: For head wounds, fractures, or knife cuts, apply medicinal paste, bind tightly with horn, prevent Wind invasion, and be cautious.
It is also said: If vital organs are injured, observe the pulse; if weak and hurried, it is critical.
*Ben Cao Gang Mu* says: Sudden falls, crushing, or beating to death can be saved if the heart remains warm. Place the person in a meditative sitting posture, have someone hold the hair low, blow powder of *Ban Xia* (Pinelliae Tuber) or *Zao Jiao* (Gleditsiae Sinensis Spina) into the nose. If revived, mix Ginger Juice and Sesame Oil evenly and pour in.
*Yi Men Ru Men* says: If medicine is unavailable, urgently open mouth and pour much hot urine.
It is also said: Traumatic injuries focus on Blood. The Liver governs Blood; regardless of meridian injured, Evil Blood returns to the Liver, flows to the hypochondrium, stagnates in the abdomen causing abdominal pain. Excess patterns require purging.
It is also said: If bleeding is excessive and hematemesis continues, it is difficult to treat. Use *Su Mu* (Sappanwood) decoction to mix and take *Bang Shuang San* (Clam Frost Powder).
It is also said: External fractures damaging sinews and bones are treatable. Internal injury to organ membranes and rupture of genitalia/ears are untreatable.
*Yi Jian* says: Wounds from knives/axes, falls from heights, or impacts damaging sinews/bones/flesh cause continuous bleeding or Blood stasis accumulation. If not removed early, toxins enter the abdomen and attack the Heart.
It is also said: After beating/falling with excessive blood loss, the pulse should be weak and fine. If rapid, large, and frequent, death ensues.
*Dan Xin* says: For falls/injuries, use *Su Mu* to invigorate Blood, *Huang Lian* to descend Fire, *Bai Zhu* to harmonize the Middle, decocted with Child's Urine. If injury is upper body, drink Leek Juice.
*Hui Chun* says: For beatings with internal Blood stasis, if the pulse is strong and firm, survival; if small and weak, death. (*Mai Jing*)
*De Xiao Fang* says: Hands and feet each have six joint dislocations and four fractures. Each hand has three dislocation points, feet three, and palm base one. Bones lock together; dislocation means slipping out of the clavicle/socket. Must manipulate bone back under clavicle into socket. If outwards, push in; if inwards, push out. Simply pulling the hand makes reduction difficult; 80-90% become chronic disabilities.
It is also said: For joint dislocations/fractures of elbows, arms, waist, knees, manipulation must restore origin. First administer麻醉药 (Anesthetic Drugs) to eliminate pain, then use manual techniques.
It is also said: For bone reduction, use a piece of bamboo; fresh willow wood board is better. Clamp one side, leave the other unclamped to allow flexion/extension. Manipulate bending and straightening frequently. Otherwise, mobility is lost after healing.
It is also said: For comminuted fractures, administer麻醉药 (Anesthetic Drugs, i.e., *Ca Wu San*) or incise with a knife. For severe cases, cut bone spurs with scissors to prevent piercing flesh. For粉碎 (comminuted) fractures, remove fine bone fragments to avoid pus/blood disasters. Wash with medicinal water daily to prevent foul odor.
It is also said: For comminuted fractures, melt bone-setting medicine over fire, paste on bone, clamp firmly. Externally apply bone-clamping methods, *Huo Xue San* (Invigorate Blood Powder), *Jie Gu Dan* (Bone-Setting Pill), *Er Sheng Gao* (Two-Life Ointment), *Nuomi Gao* (Glutinous Rice Ointment).
It is also said: For washing/rinsing, use *Man Jing San*.